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Thank you for taking the time to fill out this questionnaire.   Your answers will allow us to work more efficiently and economically on your behalf. 

PROPOSED TRADEMARK*: _______________________________________________________________ 


*If available, please attach an exact copy of the proposed mark, including all associated elements and slogans.

1. Full legal name of the owner of the proposed mark. 

(a)   If a corporation or LLC, indicate correct legal name and state of formation.  (if originally used by a predecessor organization, state its name and relationship). 

(b) If an individual, are you a citizen of the United States?

2. Address of principal place of business; and official address in state of incorporation, if different.

3. Please provide you telephone, fax, e-mail and URL information:

Telephone: ___________________

Facsimile: ___________________

E-Mail:    ___________________

Website: ___________________


4. Name and title of individual who will sign the Trademark Application:

5. Please provide a detailed description of the nature of the business with which the mark will be used.


6. Countries where you currently do business.


7. Is owner an (check one)

___ an individual.    

___ a partnership.

___ a corporation.

___ a limited liability company.

___ other (please explain)

8. (a)  Has the mark been used commercially in the United States in connection with either the sale of goods or services? 
___ Yes 
___ No.  

If your answer is “No,” please provide details of the anticipated timeline for use of the mark. 

(b) Provide specific dates of all publications (printed or online), sales, offers for sale, and public display and/or use of goods or services bearing the trademark, whether by you or by any other individual or entity, whether in the US or any foreign country.  If copies of such materials are available, please provide copies.  

(c)  What goods and/or services are intended to be offered in connection with this trademark?  

(d)  Have you secured a domain name using the proposed mark, or, perhaps, a portion of the proposed mark?  If so, please list the domain name(s) below:





9. Please provide the date of first commercial shipment across state lines of the goods or service bearing the trademark. Please state whether you have evidence of this date, and what that evidence is.  If the mark is associated with different goods or services, please provide dates relevant to type of use with each separate or specific good or service.

10.  Please provide examples (specimens) of the manner in which the trademark mark is or will be applied to products, goods, or services offered and/ or sold under the mark. Suitable specimens include labels, tags, promotional materials, brochures or packaging materials used in connection with the goods or services.  


11. Will the mark appear in logo or design form?  If so, please email us a high quality black and white JPEG or hard copy of the logo or design.


12. Will any other marks, slogans, designs or distinctive packaging be used with the mark?  If so, please describe in detail.


13. Please attach any actual or proposed advertisements, brochures, handbills, or packaging design.


14. Are there any plans to use the mark outside the U.S.  If so, when?  For what goods or services?

15. Have you ever conducted a professional trademark search to determine the availability of the mark?  If yes, please attach a copy of the trademark search report.

16.  Will the trademark be assigned to any other entity or individual?  If so, please explain. 

17.    Please let us know whether you have signed any document or agreement that in any way restricts your use or ownership of the trademark, including, in the case of book authors, any publishing contract. 

18.  Please let us know if there is anything else that might be relevant. 

19.  JPEGs or photographs of labeled goods showing the trademark as actually used on the product are also acceptable, as are containers bearing the trademark.  For internet services, screen shots, or print-outs, showing the mark as displayed are acceptable.  If you are registering goods in more than one class, or category, there must be specimens for each class.

Thank you again for taking the time to complete this questionnaire.  We look forward to going over it with you. 

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Disclaimer: The information contained in this website is not intended as legal advice. Because the law is not static, and one situation may differ from the next, we cannot assume responsibility for any actions taken based on information contained herein. Also, be aware that the law may vary from state. Therefore, this website cannot replace the advice of an experienced attorney. Receipt of this information does not create an attorney-client relationship.

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